Provider Demographics
NPI:1891462057
Name:DOYLE, KATHARINE ALLYSON (LMHC)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ALLYSON
Last Name:DOYLE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12601 W FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-6304
Mailing Address - Country:US
Mailing Address - Phone:770-344-7237
Mailing Address - Fax:
Practice Address - Street 1:12601 W FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-6304
Practice Address - Country:US
Practice Address - Phone:770-344-7237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19373101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health